There is a common misconception that BRCA1 and BRCA2 mutations only impact women because of their association with increased breast cancer risk. Everyone has BRCA1 and BRCA2 genes, and some people are born with a mutation in one of these genes. Men and women with a gene mutation in either BRCA1 or BRCA2 are at heightened risk for certain cancers, including breast cancer in both men and women, as well as ovarian, prostate, and pancreatic cancers. These gene mutations can be passed on to male and female children by either men or women.
Men with BRCA mutations can be at increased risk for certain cancers, namely breast, prostate, and pancreatic cancer, as well as melanoma. While cancer risks in male BRCA mutation carriers are not as dramatically elevated as those of female BRCA mutation carriers, and screening typically begins later in life, genetic testing, cancer risk management, and early detection can be life-saving.
The average man has a 0.1% breast cancer risk, while male BRCA1 mutation carriers have a 1-5% increased risk and male BRCA2 carriers have an increased risk of 5-10%. The average man has a 16% chance of developing prostate cancer, while BRCA2 mutation carriers have an increased risk of up to 25%. Men with BRCA1 mutations may also develop prostate cancer at a younger age than men in the general population. If the average man has a 1% pancreatic cancer risk, BRCA1 mutation carriers have a 2-3% risk and BRCA2 mutation carriers have a 3-5% risk; likewise, there is a slightly increased risk of melanoma, particularly in BRCA2 mutation carriers.
Men should consider genetic counseling and testing for BRCA1 or BRCA2 mutations if:
- They have been diagnosed with male breast cancer
- There is a known history of a BRCA mutation in the family
- There is a known history of male breast cancer, prostate or pancreatic cancer in the family
- There is a history of early breast cancer (under age 50) and/or a history of ovarian cancer in close female relatives
- The family is of Ashkenazi Jewish ancestry (Central and Eastern European)
If you are considering genetic testing, it is important to consult with a genetic counselor. Find a genetic counselor in your area or via telehealth. To help your healthcare provider assess your individual risk, family history should be collected from blood relatives on both your mother and father’s sides of the family. This includes your first degree relatives (parents, siblings, children), second degree relatives (half-siblings, grandparents, aunts, uncles), and third degree relatives (cousins, great grandparents, great-aunts, great-uncles). It is important to remember that men can inherit BRCA mutations from their mothers, so while collecting information about female breast and ovarian cancer may not seem related to male cancer risk, it is essential in the case of BRCA mutations.
If you do have a BRCA1 or BRCA2 mutation, medical management typically begins at age 35. Your oncologist or primary care physician can help shape your specific screening plan. Typically beginning at 35 to 40, male BRCA mutation carriers should begin yearly clinical breast exams with a physician. At age 40, annual prostate cancer screenings—a prostate exam and PSA blood test—are recommended for BRCA2 carriers and can be considered for BRCA1 carriers. Melanoma screening plans can be impacted by your family’s personal health history and should be guided by your dermatologist. While there are currently limited options for pancreatic cancer screening, there are ongoing clinical trials available, particularly for those with a family history of pancreatic cancer.
BRCA1 and BRCA2 in Men Fact Sheet
Ask a Genetic Counselor: BRCA & Men video
Ask Dr. Domchek: Men and BRCA Mutations video
Prostate Cancer Screening with a BRCA Mutation blog post
BRCA Mutations in Men: What You Need to Know webinar